NU 673 Assessment Midterm Exam With Complete Solutions 2024

A patient is suspected to have COPD. The APRN instructs the patient to take a deep breath in, and then with his mouth open, breathe out as fast and completely as he can. For what is the APRN checking? A. Whispered pectoriloquy B. Forced expiratory time C. Egophony D. Tactile fremitus - correct answer-B. Forced expiratory time A pt presents to the clinic with severe right sided abdominal pain for 12 hours. He began having a "stomach ache" yesterday, with decreased appetite, but today the pain seems to be just on the lower right side. He has had some nausea & vomiting, but no constipation or diarrhea. His last BM was last night and was normal. He has had no fever or chills. He denies any recent illness or injuries. His PMH is unremarkable. He denies any tobacco or drug use and drinks 4-6 beers/week. on exam, he appears ill and is lying on his right side. His temp is 100.4 F and HR is 110. His bowel sounds are decreased and he has rebound pain and guarding one third of the way between anterior superior iliac spine and the umbilicus in the right lower quadrant. What is the most likely cause of his pain? A. Acute appendicitis B. Mesenteric ischemia C. Acute mechanical intestinal obstruction D. Acute cholecystitis - correct answer-A. Acute appendicitis An APRN notes a 12 mm Hg difference in systolic BP during inspiration. How should the APRN document this finding? A. Acute stenosis B. Carotid arterial disease C. Paradoxical pulse D. Pulsus alternans - correct answer-C. Paradoxical pulse Which of the following percussion notes is obtained over a gastric bubble? A. Flatness B. Hyperresonance C. Tympany D. Resonance - correct answer-C. Tympany The APRN is performing a cardiac exam on a pt with SOB and palpitations. She listens to the heart with the pt sitting upright, then has the pt change to a supine position, and finally she has the pt turn onto the left side in the left lateral decubitus position. Which of the following valvular defects is best heard in this position? A. Mitral B. Aortic C. Tricuspid D. Pulmonic - correct answer-A. Mitral A 20 year old male has a history of leukemia and an enlarged spleen. Today he presents with a fairly significant left upper quadrant pain. On exam of the area a rough grating noise is heard. What is this sound known as? A. It is a variant of bowel noise B. It is a splenic rub C. Vascular noise D. It represents borborygmi - correct answer-B. It is a splenic rub An elderly pt with a history of smoking 2 packs/day for 50 years reports to the APRN prolonged shortness of breath. On cardiac exam, the APRN feels the most prominent palpable impulse to be in the xiphoid area. This is most likely a result of what condition? A. COPD B. Aortic stenosis C. Mitral regurgitation D. Pulmonary hypertension - correct answer-D. Pulmonary hypertension A pt reports "chest pain" during a visit to the APRN. The pt describes it as "severe" and "sharp" and worse when taking a deep breath. PMH is unremarkable and there is no history of tobacco use. VS are normal. Pt appears comfortable. Cardiac and respiratory exam are unremarkable. What is the most likely diagnosis? A. GERD B. Aortic dissection C. Myocardial infarction D. Pleuritic pain - correct answer-D. Pleuritic pain The APRN would anticipate a bounding radial pulse in: A. Aortic regurgitation B. Arterial embolism C. Mitral stenosis D. Hyperthyroidism - correct answer-A. Aortic regurgitation